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EP1226832B1 - Verfahren zur herstellung diagnostischer mittel aus mikrokapseln mit hyaluronsäure - Google Patents

Verfahren zur herstellung diagnostischer mittel aus mikrokapseln mit hyaluronsäure Download PDF

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Publication number
EP1226832B1
EP1226832B1 EP02076722A EP02076722A EP1226832B1 EP 1226832 B1 EP1226832 B1 EP 1226832B1 EP 02076722 A EP02076722 A EP 02076722A EP 02076722 A EP02076722 A EP 02076722A EP 1226832 B1 EP1226832 B1 EP 1226832B1
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Prior art keywords
microspheres
microcapsules
wall
air
forming material
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French (fr)
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EP1226832A3 (de
EP1226832A2 (de
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Andrew Derek Sutton
Richard Alan Johnson
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Quadrant Drug Delivery Ltd
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Quadrant Drug Delivery Ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/50—Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
    • A61K9/5005—Wall or coating material
    • A61K9/5021—Organic macromolecular compounds
    • A61K9/5052—Proteins, e.g. albumin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K47/00—Medicinal preparations characterised by the non-active ingredients used, e.g. carriers or inert additives; Targeting or modifying agents chemically bound to the active ingredient
    • A61K47/30—Macromolecular organic or inorganic compounds, e.g. inorganic polyphosphates
    • A61K47/42—Proteins; Polypeptides; Degradation products thereof; Derivatives thereof, e.g. albumin, gelatin or zein
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K49/00—Preparations for testing in vivo
    • A61K49/22—Echographic preparations; Ultrasound imaging preparations ; Optoacoustic imaging preparations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K49/00—Preparations for testing in vivo
    • A61K49/22—Echographic preparations; Ultrasound imaging preparations ; Optoacoustic imaging preparations
    • A61K49/222—Echographic preparations; Ultrasound imaging preparations ; Optoacoustic imaging preparations characterised by a special physical form, e.g. emulsions, liposomes
    • A61K49/223—Microbubbles, hollow microspheres, free gas bubbles, gas microspheres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/14—Particulate form, e.g. powders, Processes for size reducing of pure drugs or the resulting products, Pure drug nanoparticles
    • A61K9/16—Agglomerates; Granulates; Microbeadlets ; Microspheres; Pellets; Solid products obtained by spray drying, spray freeze drying, spray congealing,(multiple) emulsion solvent evaporation or extraction
    • A61K9/1605—Excipients; Inactive ingredients
    • A61K9/1629—Organic macromolecular compounds
    • A61K9/1658—Proteins, e.g. albumin, gelatin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00—Medicinal preparations characterised by special physical form
    • A61K9/48—Preparations in capsules, e.g. of gelatin, of chocolate
    • A61K9/50—Microcapsules having a gas, liquid or semi-solid filling; Solid microparticles or pellets surrounded by a distinct coating layer, e.g. coated microspheres, coated drug crystals
    • A61K9/5005—Wall or coating material
    • A61K9/5021—Organic macromolecular compounds
    • A61K9/5031—Organic macromolecular compounds obtained otherwise than by reactions only involving carbon-to-carbon unsaturated bonds, e.g. polyethylene glycol, poly(lactide-co-glycolide)

Definitions

  • the present invention relates to the preparation of diagnostic agents comprising hollow microcapsules used to enhance ultrasound imaging.
  • Bubble-containing liquids can be injected into the bloodstream for this purpose (see Ophir et al (1980) "Ultrasonic Imaging " 2, 67-77 , who stabilised bubbles in a collagen membrane, US-A-4 446 442 (Schering ) and EP-A-131 540 (Schering )) and US-A-4 718 433 , US-A-4 774 958 and US-A-4 844 882 disclose the use of bubbles prepared by sonicating an albumin solution. However, the size distribution of the bubbles is apparently uncontrollable and the bubbles disappear when subjected to pressure experienced in the left ventricle ( Shapiro et al (1990) J. Am. Coll. Cardiology, 16(7), 1603-1607 ).
  • EP-A-52575 discloses, for the same purpose, solid particles which have gas entrained in them, the gas being released from the particles in the bloodstream.
  • EP 458 745 discloses a process of preparing air- or gas-filled microballoons by interfacial polymerisation of synthetic polymers such as polylactides and polyglycolides.
  • WO 91/12823 discloses a similar process using albumin.
  • Wheatley et al (1990) Biomaterials 11, 713-717 discloses ionotropic gelation of alginate to form microbubbles of over 30 ⁇ m diameter.
  • WO 91/09629 discloses liposomes for use as ultrasound contrast agents.
  • the Przyborowski et al article refers to two earlier disclosures of methods of obtaining albumin particles for lung scintigraphy.
  • Raju et al (1978) Isotopenpraxis 14(2), 57-61 used the same spinning disc technique but denatured the albumin by simply heating the particles. In neither case were hollow microspheres mentioned and the particles prepared were not suitable for echocardiography.
  • One aspect of the present invention provides a process of preparing microcapsules comprising atomising a solution or dispersion of a wall-forming material in a liquid carrier into a gas in order to obtain microcapsules in evaporation of the liquid carrier, wherein the wall-forming material comprises hyaluronic acid.
  • the product obtained in the said process is subjected to a second step of reducing the water-solubility of at least the outside of the said microspheres.
  • the said two steps may be carried out as a single process or the intermediate product of the first step may be collected and separately treated in the second step. These two possibilities are referred to hereinafter as the one step and two step processes.
  • the wall-forming material and process conditions should be so chosen that the product is sufficiently non-toxic and non-immunogenic in the conditions of use, which will clearly depend on the dose administered and duration of treatment.
  • the wall-forming material may iuclude a starch derivative, a synthetic polymer such as tert-butyloxycarbonylmethyl polyglutamate ( US Patent No 4 888 398 ) or a polysaccharide such as polydextrose or starch
  • the wall-forming material (in addition to the hyaluronic acid) can be selected from most hydrophilic, biodegradable physiologically compatible polymers.
  • polymers one can cite polysaccharides of low water solubility, polylactides and polyglycolides and their copolymers, copolymers of lactides and lactones such as caprolactone, ⁇ -valerolactone, polypeptides, and proteins such as gelatin, collagen, globulins and albumins.
  • polystyrene resin examples include poly-(ortho)esters (see for instance US-A-4,093,709 ; US-A-4,131,648 ; US-A-4,138,344 ; US-A-4,180,646 ; polylactic and polyglycolic acid and their copolymers, for instance DEXON (see J.
  • Polyamino-acids such as polyglutamic and polyaspartic acids can also be used as well as their derivatives, ie partial esters with lower alcohols or glycols.
  • One useful example of such polymers is poly-(t,butyl-glutamate).
  • Copolymers with other amino-acids such as methionine, leucine, valine, proline, glycine, alamine, etc are also possible.
  • Recently some novel derivatives of polyglutamic and polyaspartic acid with controlled biodegradability have been reported (see WO 87/03891 ; US 4,888,398 and EP 130 935 incorporated here by reference).
  • polymers and copolymers with other amino-acids
  • X designates the side chain of an amino-acid residue
  • A is a group of formula -(CH 2 ) n COOR 1 R 2 OCOR(II), with R 1 and R 2 being H or lower alkyls, and R being alkyl or aryl; or R and R 1 are connected together by a substituted or unsubstituted linking member to provide 5- or 6-membered rings.
  • A can also represent groups of formulae: -(CH 2 ) n COD-CHR 1 COOR (I) and -(CH 2 ) n CO(NH-CHX-CO) m NH-CH(COOH)-(CH 2 ) n COOH (III) and corresponding anhydrides.
  • n, m and p are lower integers (not exceeding 5) and x and y are also integers selected for having molecular weights not below 5000.
  • the aforementioned polymers are suitable for making the microspheres according to the invention and, depending on the nature of substituents R, R 1 , R 2 and X, the properties of the wall can be controlled, for instance, strength, elasticity and biodegradability.
  • X can be methyl (alanine), isopropyl (valine), isobutyl (leucine and isoleucine) or benzyl (phenylalanine).
  • the wall-forming material is proteinaceous.
  • it may comprise collagen, gelatin or (serum) albumin, in each case preferably of human origin (ie derived from humans or corresponding in structure to the human protein).
  • human serum albumin (HA) derived from blood donations or from the fermentation of microorganisms (including cell lines) which have been transformed or transfected to express HA.
  • HA which term includes analogues and fragments of human albumin, for example those of EP-A-322094 , and polymers of monomeric albumin
  • EP-A-201239 and EP-A-286424 All references are included herein by reference.
  • HA "Analogues and fragments" of HA include all polypeptides (i) which are capable of forming a microsphere in the process of the invention and (ii) of which a continuous region of at least 50% (preferably at least 75%, 80%, 90% or 95%) of the amino acid sequence has at least 80% sequence identity (preferably at least 90%, 95% or 99% identity) with a continuous region of at least 50% (preferably 75%, 80%, 90% or 95%) of human albumin.
  • HA which is produced by recombinant DNA techniques is particularly preferred.
  • the HA may be produced by expressing an HA-encoding nucleotide sequence in yeast or in another microorganism and purifying the product, as is known in the art.
  • protein is used since this is what we prefer but it is to be understood that other biocompatible wall-forming materials can be used, as discussed above.
  • the protein solution or dispersion is preferably 0.1 to 50% w/v, more preferably about 5.0 - 25.0% protein, particularly when the protein is albumin. About 20% is optimal. Mixtures of wall-forming materials may be used, in which case the percentages in the last two sentences refer to the total content of wall-forming material.
  • the preparation to be sprayed may contain substances other than the wall-forming material and solvent or carrier liquid.
  • the aqueous phase may contain 1-20% by weight of water-soluble hydrophilic compounds like sugars and polymers as stabilizers, eg polyvinyl alcohol (PVA), polyvinyl pyrrolidone (PVP), polyethylene glycol (PEG), gelatin, polyglutamic acid and polysaccharides such as starch, dextran, agar, xanthan and the like.
  • PVA polyvinyl alcohol
  • PVP polyvinyl pyrrolidone
  • PEG polyethylene glycol
  • gelatin polyglutamic acid
  • polysaccharides such as starch, dextran, agar, xanthan and the like.
  • Similar aqueous phases can be used as the carrier liquid in which the final microsphere product is suspended before use.
  • Emulsifiers may be used (0.1-5% by weight) including most physiologically acceptable emulsifiers, for instance egg lecithin or soya bean lecithin, or synthetic lecithins such as saturated synthetic lecithins, for example, dimyristoyl phosphatidyl choline, dipalmitoyl phosphatidyl choline or distearoyl phosphatidyl choline or unsaturated synthetic lecithins, such as dioleyl phosphatidyl choline or dilinoleyl phosphatidyl choline.
  • physiologically acceptable emuls for instance egg lecithin or soya bean lecithin
  • synthetic lecithins such as saturated synthetic lecithins, for example, dimyristoyl phosphatidyl choline, dipalmitoyl phosphatidyl choline or distearoyl phosphatidyl choline or unsaturated synthetic lecithins
  • Emulsifiers also include surfactants such as free fatty acids, esters of fatty acids with polyoxyalkylene compounds like polyoxypropylene glycol and polyoxyethylene glycol; ethers of fatty alcohols with polyoxyalkylene glycols; esters of fatty acids with polyoxyalkylated sorbitan; soaps; glycerol-polyalkylene stearate; glycerol-polyoxyethylene ricinoleate; homo- and copolymers of polyalkylene glycols; polyethoxylated soya-oil and castor oil as well as hydrogenated derivatives; ethers and esters of sucrose or other carbohydrates with fatty acids, fatty alcohols, these being optionally polyoxyalkylated; mono-, di- and triglycerides of saturated or unsaturated fatty acids, glycerides or soya-oil and sucrose.
  • surfactants such as free fatty acids, esters of fatty acids with polyoxyalkylene compounds like
  • Additives can be incorporated into the wall of the microspheres to modify the physical properties such as dispersibility, elasticity and water permeability.
  • additives which can "hydrophobize" the wall in order to decrease water permeability, such as fats, waxes and high molecular-weight hydrocarbons.
  • Additives which improve dispersibility of the microspheres in the injectable liquid-carrier are amphipathic compounds like the phospholipids; they also increase water permeability and rate of biodegradability.
  • Additives which increase wall elasticity are the plasticizers like isopropyl myristate and the like.
  • very useful additives are constituted by polymers akin to that of the wall itself but with relatively low molecular weight.
  • the properties of the wall can be modified advantageously (enhanced softness and biodegradability) by incorporating, as additives, low molecular weight (1000 to 15,000 Dalton) polyglycolides or polylactides.
  • polyethylene glycol of moderate to low MW eg PEG 2000 is a useful softening additive.
  • the quantity of additives to be incorporated in the wall is extremely variable and depends on the needs. In some cases no additive is used at all; in other cases amounts of additives which may reach about 20% by weight of the wall are possible.
  • microspheres means hollow particles enclosing a space, which space is filled with a gas or vapour but not with any solid materials. Honeycombed particles resembling the confectionery sold in the UK as “Maltesers” (Regd TM) are not formed.
  • the space is not necessary for the space to be totally enclosed (although this is preferred) and it is not necessary for the microspheres to be precisely spherical, although they are generally spherical. If the microspheres are not spherical, then the diameters referred to above relate to the diameter of a corresponding spherical microsphere having the same mass and enclosing the same volume of hollow space as the non-spherical microsphere.
  • the atomising comprises forming an aerosol of the protein preparation by, for example, forcing the preparation through at least one orifice under pressure into, or by using a centrifugal atomizer in, a chamber of warm air or other inert gas.
  • the chamber should ideally be big enough for the largest ejected drops not to strike the walls before drying.
  • the gas or vapour in the chamber is clean (ie preferably sterile and pyrogen-free) and non-toxic when administered into the bloodstream in the amounts concomitant with administration of the microspheres in echocardiography.
  • the rate of evaporation of the liquid from the protein preparation should be sufficiently high to form hollow microspheres but not so high as to burst the microspheres.
  • the rate of evaporation may be controlled by varying the gas flow rate, concentration of protein in the protein preparation, nature of liquid carrier, feed rate of the solution and, most importantly, the temperature of the gas encountered by the aerosol.
  • an inlet gas temperature of at least about 100°C, preferably at least 110°C, is generally sufficient to ensure hollowness and the temperature may be as high as 250°C without the capsules bursting.
  • the temperature may, in the one step version of the process of the invention, be sufficient to insolubilise at least part (usually the outside) of the wall-forming material and frequently substantially all of the wall-forming material. Since the temperature of the gas encountered by the aerosol will depend also on the rate at which the aerosol is delivered and on the liquid content of the protein preparation, the outlet temperature may be monitored to ensure an adequate temperature in the chamber. An outlet temperature of 40-150°C has been found to be suitable. Apart from this factor, however, controlling the flow rate has not been found to be as useful as controlling the other parameters.
  • the intermediate microspheres comprise typically 96-98% monomeric HA and have a limited in vivo life time for ultrasound imaging. They may, however, be used for ultrasound imaging (at least in some uses of the microspheres of the invention), or they may be stored and transported before the second step of the two step process is carried out. They therefore form a further aspect of the invention.
  • the intermediate microspheres prepared in the first step are fixed and rendered less water-soluble so that they persist for longer whilst not being so insoluble and inert that they are not biodegradable.
  • This step also strengthens the microspheres so that they are better able to withstand the rigours of administration, vascular shear and ventricular pressure. If the microspheres burst, they become less echogenic.
  • Schneider et al (1992) Invest. Radiol. 27, 134-139 showed that prior art sonicated albumin microbubbles do not have this strength and rapidly lose their echogenicity when subjected to pressures typical of the left ventricle.
  • the second step of the process may employ heat (for example microwave heat, radiant heat or hot air, for example in a conventional oven), ionising irradiation (with, for example, a 10.0-100.0 kGy dose of gamma rays) or chemical cross-linking using, for example, formaldehyde, glutaraldehyde, ethylene oxide or other agents for cross-linking proteins and is preferably carried out on the substantially dry intermediate microspheres formed in the first step, or on a suspension of such microspheres in a liquid in which the microspheres are insoluble, for example a suitable solvent.
  • heat for example microwave heat, radiant heat or hot air, for example in a conventional oven
  • ionising irradiation with, for example, a 10.0-100.0 kGy dose of gamma rays
  • chemical cross-linking using, for example, formaldehyde, glutaraldehyde, ethylene oxide or other agents for cross-linking proteins and is preferably carried out on the
  • a cross-linking agent such as glutaraldehyde may be sprayed into the spray-drying chamber or may be introduced into the protein preparation just upstream of the spraying means.
  • the temperature in the chamber may be high enough to insolubilise the microspheres.
  • the microspheres may, if one wishes, consist of microspheres having a diameter of 0.05 to 50.0 m (measured in the same way as the intermediate microspheres), but ranges of 0.1 to 20.0 ⁇ m and especially 1.0 to 8.0 ⁇ m are obtainable with the process of the invention and are preferred for echocardiography.
  • a range of about 0.5 to 3.0 ⁇ m may be especially suitable for the production of a low contrast image and for use in colour Doppler imaging, whereas a range of about 4.0 to 6.0 ⁇ m may be better for the production of sharp images.
  • the second step may alter the size of the microspheres in determining the size produced in the first step.
  • the process of the invention can be controlled in order to obtain microspheres with desired characteristics.
  • the pressure at which the protein solution is supplied to the spray nozzle may be varied, for example from 1.0-10.0 x 10 5 Pa, preferably 2.0-6.0 x 10 5 Pa and most preferably about 5 x 10 5 Pa.
  • Other parameters may be varied as disclosed above and below. In this way, novel microspheres may be obtained.
  • a further aspect of the invention provides microcapsules of which at least 90% are 1.0 to 10.0 ⁇ m in diameter the walls of the microcapsule comprising hyaluronic acid.
  • Preferably more than 30%, preferably more than 40%, 50%, or 60%, of the microspheres have a diameter within a 2 ⁇ m range and at least 90%, preferably at least 95 % or 99%, have a diameter within the range 1.0-8.0 ⁇ m.
  • the interquartile range may be 2 ⁇ m, with a median diameter of 3.5, 4.0, 4.5, 5.0, 5.5, 6.0 or 6.5 ⁇ m.
  • At least 30%, 40%, 50% or 60% of the microspheres may have diameters within the range 1.5-3.5 ⁇ m, 2.0-4.0 ⁇ m, 3.0-5.0 ⁇ m, 4.0-6.0 ⁇ m, 5.0-7.0 ⁇ m or 6.0-8.0 ⁇ m.
  • a said percentage of the said microspheres have diameters within a 1.0 ⁇ m range, such as 1.5-2.5 ⁇ m, 2.0-3.0 ⁇ m, 3.0-4.0 ⁇ m, 4.0-5.0 ⁇ m, 5.0-6.0 ⁇ m, 6..0-7.0 ⁇ m or 7.0-8.0 ⁇ m.
  • the wall thickness can either be measured microscopically or can be calculated as follows.
  • r i r e 3 - r e 3 ⁇ c ⁇ 3
  • At least 75%, 90%, 95%, 98.0%, 98.5 % or 99% of the protein in the microspheres of the invention is sufficiently cross-linked to be resistant to extraction with a 1% HCI solution for 2 minutes.
  • Extracted protein is detected using the Coomassie Blue protein assay, Bradford.
  • the protein content in the washings is expressed as a percentage of the original mass of microcapsules.
  • the degree of cross-linking is controlled by varying the heating, irradiation or chemical treatment of the protein.
  • protein monomer is cross-linked and quickly becomes unavailable in a simple dissolution process, as detected by gel permeation HPLC or gel electrophoresis, as is shown in Example 8 below.
  • Continued treatment leads to further cross-linking of already cross-linked material such that it becomes unavailable in the HCl extraction described above.
  • rHA microspheres in accordance with the invention lose about 99% of HCl-extractable protein over the course of 20 minutes, whereas, at 150°C, 20 minutes' heating removes only about 5% HCI-extractable protein, 30 mins removes 47.5%, 40 mins 83%, 60 mins 93%, 80 mins 97% and 100 mins removes 97.8% of the HCl-extractable protein.
  • the microspheres may be heated at 175°C for at least 17 (preferably 20-40 mins, most preferably 35-40 mins) mins, at 150°C for at least 80 mins and at other temperatures for correspondingly longer or shorter times.
  • serum-derived albumin needs less time to cross-link than rHA.
  • the injectable microspheres of the present invention can be stored dry in the presence or in the absence of additives to improve conservation and prevent coalescence.
  • additives one may select from 0.1 to 25% by weight of water-soluble physiologically acceptable compounds such as mannitol, galactose, lactose or sucrose or hydrophilic polymers like dextran, xanthan, agar, starch, PVP, polyglutamic acid, polyvinylalcohol (PVA) and gelatin.
  • the microspheres can be milled with a suitable inert excipient using a Fritsch centrifugal pin mill equipped with a 0.5 mm screen, or a Glen Creston air impact jet mill.
  • Suitable excipients are finely milled powders which are inert and suitable for intravenous use, such as lactose, glucose, mannitol, sorbitol, galactose, maltose or sodium chloride.
  • the microspheres/excipient mixture can be suspended in aqueous medium to facilitate removal of non-functional/defective microspheres.
  • Anionic, cationic and non-ionic surfactants suitable for this purpose include poloxamers, sorbitan esters, polysorbates and lecithin.
  • microsphere suspension may then be allowed to float, or may be centrifuged to sediment any defective particles which have surface defects which would, in use, cause them to fill with liquid and be no longer echogenic.
  • microsphere suspension may then be remixed to ensure even particle distribution, washed and reconstituted in a buffer suitable for intravenous injection such as 0.15M NaCI 0.01 mM Tris pH 7.0.
  • a buffer suitable for intravenous injection such as 0.15M NaCI 0.01 mM Tris pH 7.0.
  • the suspension may be aliquoted for freeze drying and subsequent sterilisation by, for example, gamma irradiation, dry heating or ethylene oxide.
  • An alternative method for deagglomeration of the insolubilised or fixed microspheres is to suspend them directly in an aqueous medium containing a surfactant chosen from poloxamers, sorbitan esters, polysorbates and lecithin. Deagglomeration may then be achieved using a suitable homogeniser.
  • microsphere suspension may then be allowed to float or may be centrifuged to sediment the defective particles, as above, and further treated as above.
  • microspheres of this invention can be marketed in the dry state, more particularly when they are designed with a limited life time after injection, it may be desirable to also sell ready-made preparations, ie suspensions of microspheres in an aqueous liquid carrier ready for injection.
  • the product is generally, however, supplied and stored as a dry powder and is suspended in a suitable sterile, non-pyrogenic liquid just before administration.
  • At least 10% of the microspheres, when suspended in water, are capable of surviving a 0.25 s application of a pressure of 2.66 x 10° Pa without bursting, collapsing or filling with water.
  • the transient maximum pressure in the human left ventricle is about 200 mmHg (2.66 x 10 4 Pa).
  • microspheres of the invention may be produced by controlling the parameters of the spray-drying process.
  • the concentration of the wall-forming material in the liquid to be sprayed may be the same as for the microspheres described above, namely 0.1-50.0% w/v (preferably about 5.0-25.0%, especially when the wall-forming material is albumin), as may the temperature in the warm chamber (100-250°C, preferably 200-250°C) and the second step of the process, but the spraying pressure is reduced to less than 2 bar (2 x 10 5 Pa) and is preferably no more than 1.8 x 10 5 Pa, 1.5 x 10 5 Pa or 1.3 x 10 5 Pa. A minimum pressure of 1 x 10 5 Pa is preferred.
  • microspheres of the invention may be suitable for use as a deposit echocontrast agent to delineate under-perfused areas of microcirculation.
  • microspheres of mean size 15.0 ⁇ m have echogenicities some 4.6 x 10 4 fold higher than similar microspheres of mean size 5.0 ⁇ m.
  • the microspheres can be delivered by known techniques using a catheter to deliver the microspheres to, for example, the capillaries of the liver, kidney or coronary blood vessels.
  • An advantage, compared to classical radiolabelled microsphere studies, is that, following arterial administration, catheter withdrawal and patient stabilisation, multiple plane images may be taken to build a 3D perfusion map of the myocardium or similar capillary bed.
  • Regional myocardial blood flow can be qualitatively assessed in patients with coronary artery disease at the time of angiography by imaging the heart following the direct intracoronary injection of the microspheres. These microspheres are trapped in the microvasculature of the heart during the initial transmit through the coronary circulation. Since only a very small fraction of the capillaries or arterioles is embolized, no detectable adverse haemodynamic or electrophysiological effects are expected.
  • a catheter In the context of angiography, a catheter is placed within the left ventricle via insertion in the femoral artery. X-ray opaque dyes are injected both in the left ventricle and within the coronary arteries themselves. Injection of such agents enables the visualisation of vessels to the 100 ⁇ m diameter level by projecting the 3D information onto a 2D plane.
  • angiography enables stenosis of the major coronary arteries to be identified.
  • microspheres of the invention with ultrasound technology may enable the generation of multiple tomographic images and also 3D reconstruction of images.
  • perfusion beds may be delineated. Therefore, as an adjunct to angiography to identify the major causative lesion, a deposit echocontrast agent constituted by the microspheres of the invention may enable 3D perfusion territories to be identified.
  • microspheres Due to the pressure stability of the preferred microspheres, they retain air and hence echogenicity for a substantial period of time.
  • the microspheres may deposit in the vasculature following catheter administration in a manner similar to classical microsphere studies, reflecting the amount of flow to any given perfusion territory. Imaging of the territory may then be made after catheter withdrawal and patient stabilisation, to enable more optimal images in multiple planes to be gathered. Comparison with a baseline unenhanced image thus enables the perfusion, following a corrective procedure, to be assessed.
  • microspheres may be tailored for intracoronary use not only by manipulation of their size and pressure stability but also by their rate of biodegradation.
  • tissue half-life can be measured by labelling the microcapsules with 125 I by the Chloramine T method and assessing the organ content of microcapsules by necropsy or the release of 125 I into the urine and faeces.
  • microspheres of the invention are characterised by having in or on their walls a material, namely hyaluronic acid, to direct or target the microspheres to a desired location in the body.
  • microspheres of the invention are prepared by including in or on the wall of the microsphere material which alters the electrical charge of the microsphere.
  • a positive or negative charge can be imparted by applying a positively or negatively charged material, respectively, or existing positive or negative charges can be reduced or eliminated.
  • the final product (ie pressure resistant) microspheres produced by the basic one or two step process described above may be milled as described above and resuspended at a microsphere concentration of 1.0-250 x 10 6 /ml in: a 0.5-20.0% w/v solution (preferably 1.0-10.0% w/v, for example about 5%) of a positively or negatively charged material (if polymeric of 1-30 kD, preferably 5-15 kD) and incubated for 5-60 hours (preferably about 8-24 hours) at 5-30°C (preferably about 20°C).
  • positive or negative charges on microspheres may be increased by incorporating the material in the spraydrying feedstock in the range of 1-30%, preferably 2-10% w/v. This latter method is particularly preferred for polyglutamate, and for negatively charged additives generally.
  • anhydrides and chlorides of C 1-10 organic acids such as acetic, fumaric and succinic acids.
  • a final concentration of the chloride or anhydride of 5-1000 mg/ml is generally suitable, in a non-polar solvent such as dimethylformamide or tetrahydrofuran.
  • Existing negative charges on the microspheres prepared by the basic spray-drying process may be removed by exposing the microspheres to a carbodiimide agent such as N-ethyl-N'-(3-dimethylaminopropyl)carbodiimide hydrochloride (EDC), at a concentration of about 5-1000 mg/ml for a period of about 5-30 hours (preferably about 16 hours) at 5-30°C (preferably about 20°C). Excess reagent is then quenched with, for example, ethanolamine to an equivalent concentration during a further such incubation before the microspheres are washed.
  • a carbodiimide agent such as N-ethyl-N'-(3-dimethylaminopropyl)carbodiimide hydrochloride (EDC)
  • EDC N-ethyl-N'-(3-dimethylaminopropyl)carbodiimide hydrochloride
  • the electrophoretic mobility of the microspheres may be assessed in a Malvern Zeta sizer or in a Pen Kem System 3000 (USA) minielectrophoresis cell, for example for 20 particles in buffers of pH4-10.
  • the electrophoretic mobility is in one of the ranges plus or minus 0.001-5.0 x 10 -8 m/sec/v/cm. In these ranges the charge upon the microspheres alters their circulatory behaviour. More preferably, the mobility is in one of the ranges plus or minus 0.01 to 0.5 x 10 -8 m/sec/v/cm, suitably in one of the ranges plus or minus 0.1 to 0.5 x 10 -8 m/sec/v/cm.
  • the resulting microspheres may finally be formulated for storage as described above, for example suspending them in a mannitol/Pluronic F68 solution, flash freezing and freeze-drying.
  • the surface charge of microcapsules can affect the imaging properties of the product through its influence on the in vivo fate of particles. For example, it is known that after intravenous injection negatively charged polystyrene particles are taken up at high efficiency by the liver, whereas particles with a positive charge accumulate initially in the lung. Additionally, it is known that the endothelial cell surface is coated with a glycocalyx carrying a net negative charge at physiological pH values. The inner surface of endothelium may therefore be stained with collodial iron particles carrying a net positive charge.
  • a suspension of the microspheres of the invention is generally administered by injection of about 1.0-10.0 ml into a suitable vein such as the cubital vein or other bloodvessel.
  • a microsphere concentration of about 1.0 x 10 5 to 1.0 x 10 12 particles/ml is suitable, preferably about 5.0 x 10 5 to 5.0 x 10 9 .
  • ultrasonic imaging is applicable to various animal and human body organ systems, one of its main applications is in obtaining images of myocardial tissue and perfusion or blood flow patterns.
  • the techniques use ultrasonic scanning equipment consisting of a scanner and imaging apparatus.
  • the equipment produces visual images of a predetermined area, in this case the heart region of a human body.
  • the transducer is placed directly on the skin over the area to be imaged.
  • the scanner houses various electronic components including ultrasonic transducers.
  • the transducer produces ultrasonic waves which perform a sector scan of the heart region.
  • the ultrasonic waves are reflected by the various portions of the heart region and are received by the receiving transducer and processed in accordance with pulse-echo methods known in the art. After processing, signals are sent to the imaging apparatus (also well known in the art) for viewing.
  • the microsphere suspension is injected, for example through an arm vein.
  • the contrast agent flows through the vein to the right venous side of the heart, through the main pulmonary artery leading to the lungs, across the lungs, through the capillaries, into the pulmonary vein and finally into the left atrium and the left ventricular cavity of the heart.
  • the microspheres of this invention observations and diagnoses can be made with respect to the amount of time required for the blood to pass through the lungs, blood flow patterns, the size of the left atrium, the competence of the mitral valve (which separates the left atrium and left ventricle), chamber dimensions in the left ventricular cavity and wall motion abnormalities.
  • the competence of the aortic valve also may be analyzed, as well as the ejection fraction or percentage of volume ejected from the left ventricle.
  • the contrast patterns in the tissue will indicate which areas, if any, are not being adequately perfused.
  • the microspheres may permit left heart imaging from intravenous injections.
  • the albumin microspheres when injected into a peripheral vein, may be capable of transpulmonary passage. This results in echocardiographic opacification of the left ventricle (LV) cavity as well as myocardial tissue.
  • the reflected signals' strength is a function of time, which is converted to a position using a nominal sound speed, and is displayed on a cathode ray tube or other suitable devices in a manner somewhat analogous to radar or sonar displays. While DCE can be used to produce images of many organ systems including the liver, gall bladder, pancreas and kidney, it is frequently used for visualisation of tissue and major blood vessels of the heart.
  • the microspheres may be used for imaging a wide variety of areas, even when injected at a peripheral venous site. Those areas include (without limitation): (1) the venous drainage system to the heart; (2) the myocardial tissue and perfusion characteristics during an exercise treadmill test or the like; and (3) myocardial tissue after an oral ingestion or intravenous injection of drugs designed to increase blood flow to the tissue.
  • microspheres may be useful in delineating changes in the myocardial tissue perfusion due to interventions such as (1) coronary artery vein grafting; (2) coronary artery angioplasty (balloon dilation of a narrowed artery); (3) use of thrombolytic agents (such as streptokinase) to dissolve clots in coronary arteries; or (4) perfusion defects or changes due to a recent heart attack.
  • interventions such as (1) coronary artery vein grafting; (2) coronary artery angioplasty (balloon dilation of a narrowed artery); (3) use of thrombolytic agents (such as streptokinase) to dissolve clots in coronary arteries; or (4) perfusion defects or changes due to a recent heart attack.
  • an injection of the microspheres may provide data with respect to tissue perfusion characteristics that would augment and complement the data obtained from the angiogram procedure, which identifies only the anatomy of the blood vessels.
  • microspheres of the present invention may be suitable for enhancement of such currently obtainable images, and/or the generation of new images showing perfusion and flow characteristics that had not previously been susceptible to imaging using prior art ultrasonic imaging techniques.
  • a suitable spray dryer ( Figure 1 ) is available from A/S Niro Atomizer, Soeborg, Denmark under the trade designation "Mobile Minor”. Details of its construction are given immediately before the claims herein. It comprises a centrifugal atomizer (Type M-02/B Minor), driven by an air turbine at an air pressure of min 4 bar and up to max 6 bar. At 6 bar an atomizer wheel speed of approx 33,000 rpm is reached. Turning on and off the compressed air to the atomizer is done by means of a valve placed in the instrument panel. The maximum consumption of compressed air to the atomizer is 17 Nm 3 /h at a pressure of 6 bar.
  • All parts coming into contact with the liquid feed and powder are made of stainless steel AISI 316, except for the pump feed tube and the atomizer wheel, which is made of stainless steel AISI 329, made to resist high centrifugal force.
  • the stainless steel interconnecting pipe system 4 can easily be stripped down for cleaning.
  • the drying chamber has an inside made of stainless steel AISI 316, well insulated with Rockwool, and covered outside with a mild steel sheeting.
  • the drying chamber is provided with a side light and observation pane for inspection during the operation and steps 5 for access to the chamber top.
  • the roof of the drying chamber is made inside of stainless steel AISI 316 and outside of stainless steel AISI 304.
  • An air disperser 2 made of stainless steel AISI 304 is used for distribution of the air in the drying chamber in order to achieve the best possible drying effect. Swirling air is directed around the vaned disc atomiser.
  • An air duct, made of stainless steel AISI 316, provides lateral transportation of the exhaust air and the powder to the cyclone 7, which is made of stainless steel AISI 316 and designed to separate the powder and air.
  • a closing valve of the butterfly valve type also made of stainless steel AISI 316 and having a gasket of silicone rubber, is used for powder discharge under the cyclone into a powder collecting glass jar 8 tightly placed under the cyclone by means of a spring device.
  • a centrifugal exhaust fan 10 made of silumin, complete with 3-phase squirrel-cage motor, 0.25 kW, and V-belt drive with belt-guard, draws air and powder through the drying chamber and cyclone.
  • An air heater 12 heats the drying air by means of electricity (total consumption 7.5 kWh/h, infinitely variable) and can give inlet air temperatures of up to about 350°C, although this is generally too high for preparing the microspheres of the invention.
  • the evaporative.capacity is as follows:
  • Equipment for two-fluid nozzle atomization may be added, which is made of stainless steel AISI 316, consisting of entrance pipe with nozzle holder and nozzle, to be placed in the ceiling of the drying chamber.
  • the equipment includes an oil/water separator, reduction valve and pressure gauge for compressed air to the two-fluid nozzle. Consumption of compressed air: 8-15 kg/h at a pressure of 0.5-2.0 bar (0.5-2.0 x 10 5 Pa).
  • a suitable feed pump for transport of wall-forming preparation feed from a reservoir 1 to the atomizer nozzle 3 is a peristaltic pump.
  • the pump is provided with a motor (1 x 220V, 50 Hz, 0.18 kW) and a continuously variable gear for manual adjustment.
  • a feed pipe made of silicone hose leads from a feed tank (local supply) I through the feed pump to the rotary or nozzle atomization device 3.
  • An absolute air filter consisting of prefilter, filter body in stainless steel and absolute air filter, is used for the treatment of the ingoing drying air to render it completely clean.
  • the whole apparatus is controlled via an instrument panel 9.
  • a 20% solution of sterile, pyrogen-free rHA in pyrogen-free water (suitable for injection) was pumped to the nozzle of a two fluid nozzle atomiser mounted in the commercial spray drying unit described above.
  • the peristaltic pump speed was maintained at a rate of approximately 10 ml/minute such that with an inlet air temperature of 220°C the outlet air temperature was maintained at 95°C.
  • Compressed air was supplied to the two fluid atomising nozzle at 2.0-6.0 Bar (2.0-6.0 x 10 5 Pa). In this range microspheres with a mean size of 4.25-6.2 ⁇ m are obtained.
  • Method 1 involved first mixing the heat fixed spheres with an equal weight of finely milled lactose (mean diameter 5 ⁇ m). The mixture was then passed through a Fritsch centrifugal mill with a 0.5 mm screen and 12 tooth rotor. The milled spheres were collected and passed through the mill a second time to ensure complete mixing had occurred. The milled powder was then resuspended in water containing 1 mg.ml -1 Pluronic F68. Typically 10 g of microspheres and lactose was added to 100 ml of water and Pluronic F68.
  • Method 2 for deagglomeration involves adding 5 g of the heat-fixed microspheres to 100 ml of water containing 100 mg of Pluronic F68.
  • the microspheres were dispersed using a Silverson homogeniser (model L4R with a 2.54 cm tubular homogenising probe and a high shear screen) and homogenising for 60 seconds.
  • the resuspended spheres were separated into intact (gas containing) and broken spheres using a flotation technique.
  • the gas-containing spheres were seen to float to the surface over a 1 hour period and were decanted from the sinking fraction which does not contain the gas required.
  • the separation process can be accelerated by centrifugation.
  • a 30 second centrifugation at 5000 x g is sufficient to separate the two fractions.
  • microspheres were freeze-dried in the presence of lactose and Pluronic F68.
  • Optimal conditions for freeze drying involved resuspending 30 mg of microspheres in 5 ml of water containing 50 mg of lactose and 5 mg of Pluronic F68.
  • the freeze-dried microspheres can be redispersed in a liquid (eg water, saline) to give a monodisperse distribution.
  • Example 1 The process of Example 1 was repeated but with the following differences in the first step: a centrifugal atomiser was used instead of a two fluid nozzle; the inlet temperature was 150°C (with the outlet air temperature still being sustained at 105°C); and compressed air was supplied to the nozzle at 1.0-6.0 x 10 5 Pa.
  • the second step of the process of Example 1 or 2 was varied as follows. A small aliquot of the microspheres (0.5 g) was heated in a microwave oven such that it received 300-350 watt hours of microwave heat at 2500 mHz. This yielded microspheres in which 90-95% of the monomeric rHA was insoluble (as determined by gel permeation chlomatography) and as a result of this heat fixation their in vitro echogenic half-life increased from a few seconds to in excess of 30 minutes.
  • the second step of the process of Example 1 or 2 was varied as follows. A small aliquot of the microspheres (0.5 g) was sealed under argon in a glass vial. The vial was cooled to 4°C and then irradiated with a 60 Co gamma radiation source to deliver a 15.0 kGy dose of gamma rays. The irradiation resulted in the formation of microspheres in which 10-15% of the monomeric albumin was insoluble.
  • the second step of the process of Example 1 or 2 was varied as follows.
  • a small aliquot of the microspheres (0.5 g) was sealed under argon in a glass vial.
  • the vial was cooled to 4°C and then irradiated with a 60 Co gamma radiation source to deliver a 50.0 kGy dose of gamma rays to the microspheres.
  • the microspheres were incubated in oxygen at 50°C for 6 hours. The irradiation resulted in the formation of microspheres in which 50-60% of the monomeric rHA was insoluble.
  • the second step of the process of Example 1 or 2 was varied as follows.
  • microspheres 0.5 g was resuspended in 5 ml of ethanol, chloroform or methylene chloride containing a) 1.5% glutaraldehyde, b) 2.0% diphthaloyl chloride or c) 5.0% formaldehyde.
  • the microspheres were stirred for varying times from 10 minutes to 3 hours.
  • the microspheres were removed by filtration and washed thoroughly in the original organic buffer containing 5% ethanolamine, in order to remove excess cross-linking agent. Finally the microspheres were washed in organic solvent and vacuum dried to remove any residual solvents.
  • the extent of insolubilisation may be varied from 5-100% by this method resulting in the extension of in vitro echogenic half-life from 1-2 minutes to in excess of one hour.
  • microsphere formation and insolubilisation of the shell may be combined in a single process.
  • formation of the microspheres and the insolubilisation of the polymeric material are achieved simultaneously during the spray drying process.
  • a solution of rHA was fed by peristaltic pump to a small reaction chamber, with a separate feed line supplying a 5% solution of a suitable crosslinking agent, eg glutaraldehyde, diphthaloyl chloride or formaldehyde.
  • a suitable crosslinking agent eg glutaraldehyde, diphthaloyl chloride or formaldehyde.
  • the residence time in the reaction chamber was such that initial adduct formation between the crosslinking agent and the protein was achieved, but intraprotein crosslinking was prevented.
  • the reaction vessel outlet was fed directly to the two fluid nozzle atomisers mounted in a specially adapted spray drying unit, capable of handling volatile solvents. The conditions of spray drying were as outlined in Example 1.
  • microspheres were incubated dry at room temperature to allow intraprotein crosslinks to form and then suspended in ethanol containing 5% ethanolamine to quench any remaining crosslinking agent. Thorough washing of the microspheres was performed and finally the microspheres were vacuum dried to remove residual solvent.
  • a 1 ml volume of ethanol was added to 100 mg of microspheres in a 20 ml glass bottle and sonicated for 30 seconds. To this suspension 19 ml of H 2 O were added.
  • the mixture was centrifuged in a bench-top microfuge (Gilson) for 20 seconds and the clear fraction assayed.
  • the assay was performed by loading 50 ml of the fraction automatically onto a Shimadzu LC6A HPLC and chromatographing on a TSK gel permeation column at a flow rate of 1 ml minute -1 using sodium phosphate buffer (pH 7.0).
  • the peak heights representing the rHA monomer were recorded and used to determine the concentration of monomer using a standard curve between 1 and 10 mgml -1 monomeric rHA.
  • the %-free monomeric rHA was calculated by measuring the monomer concentration in the fixed microspheres and representing this figure as a percentage of the monomer concentration of the unfixed microspheres. The results are given in Figure 2 .
  • Heating of the spray dried microspheres in an oven results in a decrease in the amount of monomer that can be detected (see Figure 2 ).
  • This decrease in detectable monomeric rHA is due to the denaturation and crosslinking of monomeric rHA into insoluble polymers that cannot be assayed by the aforementioned HPLC method.
  • microspheres By careful control of temperature and time of incubation, it is possible to produce microspheres with a controlled range of crosslinking (and hence pressure resistivity and biodegradation rate).
  • a batch of rHA microspheres from the initial spray-drying step of the process was divided into 5 g aliquots and baked at 175°C for varying lengths of time as shown in Figure 3 .
  • the heat-fixed microspheres were disaggregated using a Fritsch centrifugal mill (as described above) and intact, air-containing microspheres recovered by the aforementioned flotation technique.
  • the recovered microspheres were suspended in H 2 O containing Pluronic F68 (1 mgml -1 ) at a concentration of 0.5 x 10 8 capsules ml -1 .
  • the resuspended, air-containing microspheres were subjected to increased atmospheric pressure by applying pressure with a 50 ml syringe whilst containing this suspension in a closed container (25 ml polystyrene container).
  • the individual microsphere suspension was pressurised to the selected pressure and maintained at this pressure for 5 seconds before releasing the pressure.
  • the pressure increase was performed 3 times.
  • the pressure in the closed container was assessed by an RS hand-held manometer.
  • microsphere suspensions were assessed by light microscopy and image analysis and the % air-containing to non-air-containing microspheres assessed. This analysis is performed since only the air-containing microspheres are functional in enhancing ultrasound echocontrast.
  • microspheres that are fixed for 60 minutes at 175°C, as described in Example 1, are stable at all of the pressures to which they were subjected in this experiment.
  • the temperature used to crosslink the microspheres can vary infinitely, as can the length of incubation time.
  • An advantage of the process of the invention is that it enables the median size and size distribution of the microspheres to be controlled. However, one can further select desired sizes if one wishes, for example by flotation. In a homogeneous dispersion of microspheres, larger particles will rise to the surface faster than smaller particles due to the lower density (more encapsulated air) of the larger particles. Hence, by allowing the dispersion to stand, the particle size distribution will change at any level of the solution with respect to time.
  • Microspheres were dispersed in 2000 ml of aqueous solution containing 6% w/v sodium chloride and 0.1% w/v Pluronic F68 in a glass bottle giving a liquid column of approximately 165 mm.
  • a sampling tube was placed 50 mm below the upper liquid surface to enable removal of samples at timed intervals.
  • a solution of human albumin (5% w/v) is spray-dried at an inlet temperature of 220°C and an air pressure of 1.5 bar as in General Preparation Example 1.
  • the resulting particles are heat fixed for a period of 20 minutes at 175°C in an air oven.
  • the samples are deagglomerated by milling with mannitol and the particles are resuspended in a solution of 10 mg/ml mannitol and 0.06 mg/ml pluronic F68.
  • the intact particles are creamed off and the microsphere suspension is freeze-dried.
  • Particles predominantly of 10-20 ⁇ m are produced which contain air and are substantially pressure resistant.
  • Polylysine at a concentration of 5% w/v was resuspended with the microspheres of General Preparative Example 2 (100 x 10 6 particles/ml) and incubated overnight at 20°C. Mannitol and Pluronic F68 were added at the concentration described in Specific Example 1 and the suspension was subsequently flash frozen and freeze dried.
  • Hyaluronic acid at a concentration of 5 % w/v was incubated overnight with resuspended microspheres prepared as in General Preparative Example 1 at 20°C (100 x 10 6 microspheres/ml). Mannitol and Pluronic F68 were added to a concentration of 10 and 0.06 mg/ml respectively and the suspension then flash frozen and freeze dried.
  • Microspheres according to General Preparative Example 3 were resuspended in a solution of DMF (Dimethylformamide) at a concentration of 100 x 10 6 particles/ml. Acetic anhydride was added to give a final acid anhydride concentration of 100 mg/ml. The microsphere mixture was incubated at 20°C for 1 hour then diluted with water and filtered and washed with excess water over a 1 hour period. The microspheres were formulated in Mannitol and Pluronic F68 as described above. This method imparts negative charges.
  • DMF Dimethylformamide
  • Microspheres according to General Preparative Example 1 were resuspended in an aqueous solution at a concentration of 100 x 10 6 particles/ml.
  • An aqueous solution of carbodiimide was added to the microsphere suspension to give a final concentration of 100 mg/ml.
  • excess reagent was quenched by the addition of glycine to an equivalent concentration and further incubation for 16 hours at 20°C.
  • the microspheres were washed with water then formulated as described above. This procedure eliminates negative charges.
  • Poly-L-lysine (15-25 kDa) was added to the rHA feedstock (20% w/v) to a final concentration of 0.5% w/v prior to spray drying.
  • the method of general example 2 was followed to yield microcapsules with increased positive charge upon the shell.
  • Poly-L-glutamate (15-30 kDa) was added to the rHA feddstock (20% w/v) to a final concentration of 0.5% w/v prior to spray drying.
  • the method of general preparative example 2 was followed to yield microcapsules with increased negative charge upon the shell.
  • Microspheres of General Preparative Example 11 may be used in an in vivo analysis to establish the feasibility of delineating perfusion territories in the myocardium of a pig heart.
  • a 25 kg England swine is anaesthetised and fully ventilated according to the methodology outlined in Ten Cate et al (1992) Cardiovascular Research 26, 32-39 .
  • a 5 French catheter is inserted via the femoral artery, ascending aorta and aortic root into the left ventricle.
  • Injection of 4 million microcapsules of General Preparative Example 11 is made and 2 dimensional transthoracic echocardiography in the short axis plan using a Hewlett Packard sono's 1000, equipped with a 3.5 MHz transducer, is used to assess regional perfusion.

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Claims (7)

  1. Verfahren zur Herstellung von Mikrokapseln, wobei das Verfahren das Zerstäuben einer Lösung oder Dispersion von mindestens einem wandbildenden Material in einem flüssigen Träger in ein Gas zur Gewinnung von Mikrokapseln durch Verdampfen des flüssigen Trägers umfasst, wobei das wandbildende Material Hyaluronsäure umfasst.
  2. Mikrokapseln, von denen mindestens 90% einen Durchmesser von 1,0 bis 10,0 µm aufweisen, wobei die Wände der Mikrokapseln Hyaluronsäure umfassen.
  3. Sterile pyrogenfreie Zubereitung von Mikrokapseln nach Anspruch 2 oder Mikrokapseln, die durch das Verfahren nach Anspruch 1 hergestellt wurden.
  4. Mikrokapseln nach Anspruch 2 oder Mikrokapseln, die durch das Verfahren nach Anspruch 1 hergestellt wurden, zur Verwendung in der Medizin.
  5. Mikrokapseln nach Anspruch 2 oder Mikrokapseln, die durch das Verfahren nach Anspruch 1 hergestellt wurden, zur Verabreichung an den Körper von Menschen oder Tieren.
  6. Verwendung von Mikrokapseln nach Anspruch 2 oder Mikrokapseln, die durch das Verfahren nach Anspruch 1 hergestellt wurden, bei der Herstellung eines Diagnosekontrastmittels.
  7. Verfahren zur Erzeugung eines Bildes zur anschließenden Inspektion, wobei das Verfahren (a) das Injizieren von Mikrokapseln nach Anspruch 2 oder Mikrokapseln, die durch das Verfahren nach Anspruch 1 hergestellt wurden, in den Körper eines Säugers, (b) das Einwirken von geeigneter Ultraschallstrahlung auf den Säuger oder einen Teil desselben und (c) das Detektieren von Ultraschallstrahlung, die von den Mikrokapseln reflektiert wurde, von diesen durchgelassen wurde, mit diesen in Resonanz war oder von diesen frequenzmoduliert wurde, umfasst.
EP02076722A 1992-10-10 1993-10-08 Verfahren zur herstellung diagnostischer mittel aus mikrokapseln mit hyaluronsäure Expired - Lifetime EP1226832B1 (de)

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US6015546A (en) 2000-01-18
US6416741B1 (en) 2002-07-09
US20050238586A1 (en) 2005-10-27
EP0663840B1 (de) 2003-12-10
EP1226832A3 (de) 2004-01-02
GB2302650A (en) 1997-01-29
EP1226832A2 (de) 2002-07-31
ATE451127T1 (de) 2009-12-15
US6344182B1 (en) 2002-02-05
HK1007960A1 (en) 1999-04-30
JPH08505366A (ja) 1996-06-11
CA2146783C (en) 2009-05-26
HK1007958A1 (en) 1999-04-30
GB2302650B (en) 1997-04-09
GB2286122B (en) 1997-04-09
US6348186B1 (en) 2002-02-19
WO1994008627A1 (en) 1994-04-28
GB9507191D0 (en) 1995-05-31
ATE255911T1 (de) 2003-12-15
ES2214477T3 (es) 2004-09-16
US20030133876A1 (en) 2003-07-17
DE69334304D1 (de) 2010-01-21
US6939530B2 (en) 2005-09-06
ES2356372T3 (es) 2011-04-07
JP2006273874A (ja) 2006-10-12
US5957848A (en) 1999-09-28
EP0663840A1 (de) 1995-07-26
GB2302649B (en) 1997-04-09
DE69333345T2 (de) 2004-10-07
GB9221329D0 (en) 1992-11-25
DK0663840T3 (da) 2004-03-29
DE69333345D1 (de) 2004-01-22
GB9616117D0 (en) 1996-09-11
CA2146783A1 (en) 1994-04-28
GB2302649A (en) 1997-01-29
GB9616116D0 (en) 1996-09-11
HK1007959A1 (en) 1999-04-30
GB2286122A (en) 1995-08-09

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